Individual
KELLY K RANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, FNP, CS
Contact information
Practice address
12639 OLD TESSON RD, SAINT LOUIS, MO 63128-2786
(314) 849-0311
(314) 849-4423
Mailing address
1165 N BUTTERFIELD RD, BOLIVAR, MO 65613-1056
(417) 777-8131
(417) 777-8892
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
099454
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427759113
—
MO
Enumeration date
11/29/2006
Last updated
10/25/2011
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